By Glenn C. Kharkongor
In the last one month, among my circle of friends and colleagues, four families have been affected with positive cases, hospitalizations and one tragic death. In all these families, each child tested positive, one as young as two years of age. The children have been isolated at home with one parent, also positive, with food being left at the door by relatives. These small children cannot understand why they can only wave to an aunt or a grandparent from the window. One exposed frontline worker had to be isolated at home in his own room, sequestered from the family. His young daughter was distraught, sobbing, “Is papa going to die?”
In the din of Covid, the voiceless are mute spectators, suffering their quiet fate amid the clangour of the pandemic. Their world has become even more harsh: domestic violence for women has increased, migrant workers have suffered a second economic devastation. Even the highly visible health workers, not belonging to powerful trade unions or influential lobbies, do not have health insurance cover from the government or any other meaningful support.
Children have been under the Covid radar. From the beginning of the pandemic we have been reassured by glib statements that children are at low risk. In the colourful graphics in the newspapers or TV, there is no breakdown to show statistics for children. One of the few stated worries is that if schools are opened, will the children contract Covid at school and bring the infection home to the adults? Such has been the sidestepping of children in conversations about Covid.
More cases in the second wave
The second wave has been vastly different for children. The new variants, being more infective, have been affecting children in much larger numbers and with greater severity. Yet still, demographic data for infected Indian children is hard to find. All we can rely on are anecdotal reports that are truly alarming. Just two districts in Rajasthan reported more than 600 Covid cases in children over a few days last week.
In the month of April 2021, more than sixty thousand cases in children were reported in Maharashtra. Entire families including infants have quickly turned positive if one member was affected. The Maharashtra government has directed health authorities and the public to be alert for symptoms in children. Addressing over 6,300 paediatricians virtually, the chief minister said vigilance and immediate diagnosis was the need of the hour for children.
The World Health Organisation (WHO), in an October 2020 document, reported that Covid-19 among children and adolescents, being 29% of the global population, represented about 8% of reported cases. In the USA, children account for 22% of the population and 14% of the cases. In India, if we extrapolate the lower figure of 8%, it would mean that so far there have been more than two million affected children.
India Today opened a recent feature article with the statement, “Covid-19 may have turned severe and even deadly for thousands of children in India”. The real number is apparently unknown.
Unlike in the first wave, Covid has turned more severe for children. According to the Indian Academy of Pediatrics, more than two thousand cases of multi-system failure, affecting the hearts, lung and brain, have been reported in children so far, some with fatal results. Sir Ganga Ram Hospital in Delhi alone had 140 cases.
The National Commission for Protection of Child Rights, the country’s apex child rights body, has asked the Centre and states to ramp up their preparations and services to protect children and infants.
Children vulnerable in many ways
Poverty and malnutrition are factors that grind out a vicious circle for children. Malnourished children have weaker immune systems rendering them more susceptible to infectious diseases. A report from Azim Premji University released earlier this month has estimated that Covid has pushed an additional 230 million Indians below the poverty line. Imagine the huge number of malnourished children that will be added to the already high numbers in our country.
The fifth National Family Health Survey (2019-20) released a few months ago has shown that in Meghalaya, the infant mortality rate and the under-five mortality rate has actually increased since the last survey in 2015-16. How come these unforgiveable statistics are never highlighted in the media or by the government?
In Meghalaya, the prevalence of underweight, wasting and stunting remains high. In preschool children, the prevalence of stunting is 46.5%, perhaps the highest in the country and has increased from 43.8% in the last survey. Stunting indicates chronic malnutrition over a period of years, and almost half our children have suffered in this way.
Children who have lost parents have been rendered orphans. Delhi has announced special schemes for these children, whose lives have been traumatised forever. A UNICEF India official has called for speedy help for children, saying that “children are being orphaned and we do see that there is a lot of trafficking of children”.
According to the American Psychological Association, there has been a spike in child abuse in the USA during lockdowns. Child abuse has increased in India as well. The key risk factors include overstressed caregivers becoming violent or abusive due to economic stress, and children’s restricted mobility as schools are closed. Childline India Foundation has reported a 50% increase in phone calls during the lockdown. Of the calls received during this period, 30% were related to protection from abuse.
When we know that 93% of perpetrators are relatives or known individuals, child sexual abuse can be devastating, as the isolation of lockdown has made it even more difficult for victims to seek help or escape. Children are subjected to unimaginable feelings of helplessness and mental health consequences. Another vulnerable population of children are the homeless, rag pickers, and those who beg on the streets. Thousands are being exploited in exchange for a meal or a daily wage just enough to sustain themselves. With lockdown, the usual crumbs obtained on the streets ae no longer there.
According to Childline India Foundation, the most heart-wrenching calls to their helpline are the now regularly received “silent calls”. The child behind the call does not know what to say or how to express it.
Those who are from my generation will remember this song by the Carpenters, the side B of a record released in 1971.
Bless the beasts and the children
For in this world they have no voice
They have no choice.
Half a century on, is the world a better place for children?
(The author is a former professor of pediatrics and can be reached at [email protected])